Ventricular-arterial coupling assessed by PWV/GLS ratio in hypertensive patients.

ABSTRACT

OBJECTIVE: The physiological interaction between the left ventricle (LV) and the arterial system, defined as ventricular-arterial coupling (VAC), facilitates the optimal volume of cardiac work and cardiovascular performance. The aim of this study was to evaluate the benefit of PWV/GLS ratio associated with other vascular and cardiac performance parameters in hypertensive patients compared to age-matched healthy controls. PATIENTS AND METHODS: We calculated the ratio of pulse wave velocity (PWV), as a marker of arterial stiffness, to global longitudinal strain (GLS), as a marker of left ventricular function in 135 patients divided in 3 groups, as follows group 1 (HT + CAD) enrolled 54 hypertensive patients with coronary artery disease, group 2 (HT) enrolled 43 hypertensive patients and group 3 (CON) represented the control group consisting of 38 age-matched healthy subjects. RESULTS: GLS values were significantly reduced in HT+CAD (-17.50±7.2) vs. HT (-17.95±5.3) vs. control (-20.13±4.6) (p-value <0.001). PWV values were higher in HT+CAD (9.90±3.1) and HT (9.70±2.5) vs. control (7.85±3.2) (p-value <0.001). VA coupling measured by the PWV/GLS ratio showed significantly lower values in HT+CAD and HT vs. control (p-value <0.001). The ROC curve identified a threshold of -0.054 of the PWV/GLS ratio to detect altered ventricular-arterial coupling AUROC = 0.836, 95% CI [0.762; 0.909]. CONCLUSIONS: This study demonstrated that assessment of the PWV/GLS ratio represents a useful tool to detect altered ventricular-arterial coupling in hypertensive patients. The perspectives of future use could include monitoring of earlier development of multiple organ damage in hypertensive patients and the efficacy of the different hypertensive medications. Extensive prospective studies are needed to confirm this hypothesis.